Article information
Abstract
Bisphosphonates are chemical compounds which mainly act on bone metabolism by inhibiting bone resorption. Their main indication is currently the treatment of postmenopausal osteoporosis, but they can also be used in other diseases that involve an increase in bone resorption.
They have been shown to be beneficial in some paediatric diseases, such as osteogenesis imperfecta, particularly in the more severe forms, polyostotic fibrous dysplasia, patients with severe neuromuscular involvement, and corticosteroid-induced osteoporosis. New indications are also being studied experimentally, such as in Perthes disease or bone lengthening by distraction osteogenesis.
Although experience with bisphosphonates in these diseases is limited, and there is also little consensus as regards the most suitable type of bisphosphonate, the dose to use, the form of administration and on the duration of treatment.
The long-term secondary effects are still not well known, so caution must be used when using them in growing patients and particularly in girls when reaching fertile age.
Keywords:
Bisphosphonates
Osteoporosis
Osteogenesis imperfecta
Fibrous dysplasia
Resumen
Los bifosfonatos son compuestos químicos cuya principal acción sobre el metabolismo óseo es la inhibición de la reabsorción ósea. Su principal indicación médica, actualmente, es el tratamiento de la osteoporosis postmenopáusica, pero también puede administrarse en otras patologías que cursan con aumento de la reabsorción ósea.
Dentro de las patologías pediátricas han demostrado ser beneficiosos en la osteogénesis imperfecta (OI), especialmente, en las formas más graves, displasia fibrosa poliostótica, pacientes con grave afectación neuromuscular, osteoporosis secundaria al tratamiento con corticoides y también de forma experimental se están estudiando nuevas indicaciones como en la enfermedad de Perthes o en los alargamientos por distracciónosteogénesis.
La experiencia con estos fármacos en este tipo de patología aún es pequeña y existe todavía poco consenso en cuanto al tipo de bifosfonato, dosis, forma de administración más adecuada y duración del tratamiento.
Los efectos secundarios a largo plazo aún no son totalmente conocidos, por lo que debemos ser cautos a la hora de utilizarlos en este tipo de pacientes en crecimiento y sobre todo en las niñas al llegar a la edad fértil.
Palabras clave:
Bifosfonatos
Osteoporosis
Osteogénesis imperfecta
Displasia fibrosa
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